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Dr. Bell is running the group therapy session when Monk comes in late. He meets the antisocial and aggressive patient Rhonda, and Augie, who is afraid of everything — but the fourth patient in the group is Monk's old nemesis, Harold Krenshaw! Nothing's changed between them, and the group therapy session turns nasty. It also turns out that Barbara O'Keefe was a part of this group before she died.

Natalie tries to help Monk look on the bright side of group therapy while they shop at the grocery store, but Harold Krenshaw shows up there too. Monk accuses Harold of following him, but Harold defends himself saying that a lot of Dr. Bell's patients come here after therapy, including Xavier Danko, who is currently shopping for cleaning supplies. Harold tells them that Xavier was obsessed with an exotic dancer, but five weeks ago was cured and left group. Harold wants to be cured next, and tries to get Monk to leave the group. To spite Harold, Monk refuses to quit.

The next day, Monk joins Stottlemeyer and Disher at a crime scene where Augie, the fearful patient from group therapy, has apparently committed suicide by jumping off a building. Monk concludes from the lack of hair on Augie's wrists that he was actually tied up and pushed off the building. This was murder. Monk realizes two people have died from his group, and after looking at Barbara O'Keefe's file, sees that her death was murder and not an accidental drowning, as the police thought. Monk can't help but be slightly pleased that the numbers in his therapy group are dropping.

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